The relationship of health histories, health care and health outcomes

Please elaborate upon the role of gender and ethnicity in your discussion of health
outcomes as well. What are the differences in health outcomes related to gender and
ethnicity? What are the causes of these disparities in the health of older individuals? Be
sure to discuss cumulative disadvantages in relation to health and illness.
The paper must be two to three pages in length (excluding the title and reference page),
and formatted according to APA style. You must use at least two scholarly sources to
support your points. Cite your sources within the text of your paper and on the reference

The relationship of health histories, health care and health outcomes for older Americans
Older Americans often encounter unique health care challenges. According to the
National Council on Aging (CNOA), many older Americans are not supported in Medicare’s
current systems of payment, which tend to promote high volume, high-intensity fragmented care
and can undermine quality (2013). The older population, those over the age of 65 is composed of
people from diverse ethnic groups, one in six being from a minority group. The quality of care
provided to these people also varies to some degree in relation to ethnicity. This paper discusses
the relationship of health histories, health care as well as health outcomes for older/senior
Caring for older Americans involves clinical complexities and it has a considerable
impact/effect on their functional status, and thus, their quality of life. In the United States,
Medicare covers various services including physician services, inpatient hospital care, home
health care, hospital outpatient, skilled nursing facility care as well as hospice services.
Utilization rates for several services change with time mainly due to changes in physician
practice patterns, Medicare payment amounts, medical technology and patient demographics.
The most commonly occurring chronic illnesses/conditions among the elderly include arthritis,
hypertension, cancer, heart disease and diabetes (CNOA, 2013).

All older people in the United States should have equal access to the best or high quality
care. Instead, ethnic and racial minorities, and to some degree women, often face more barriers
to healthcare and receive lower quality care when they can get it. Agency for Healthcare
Research and Quality (AHRQ) reported that for the United States medical system, gender and
ethnicity differences regarding health and use of health services have been a long-standing issue
(2011). These differences are clearly documented in physician and home care use, outpatient
surgery, hospital service as well as preventive services. Generally, older African Americans
receive worse health care compared to Whites for 41% of quality measures. Moreover, Hispanics
receive worse care than non-Hispanic whites for 39% of measures. Poor older Americans receive
worse care than older high-income people for 47% of measures (AHRQ, 2011). Health and
largely the use of health services among older Americans are of special concern. This is
primarily due to the older Americans’ heavy use of medical services, which is mostly paid
through Medicare. Since women make up the majority of Medicare beneficiaries, attaining
equitable use of these services by men and women is paramount. Gender and ethnicity
differences in income, education and wealth are long recognized and acknowledged as being
greatest among the older Americans. Consequently, these differences could translate into
reduced access to health care services that in turn, might influence the use of medical care
(CNOA, 2013).
There are many causes to these disparities in the health of older individuals. The first one
is lack of financial resources, and this has created a barrier to health access for many women and
minority ethnic groups. The second cause is the scarcity of providers. In inner cities and
communities with high populations of minorities, the access to medical care may be limited
because of insufficiency of primary care practitioners, specialists, and diagnostic facilities

(AHRQ, 2011). The third cause is the lack of diversity within health care workforce. The cultural
differences between the ethnic minority patients and the predominantly white health care
providers, has played a role with regard to accessing care. CNOA (2013) reported that only 5%
of physicians are Hispanics and 4% are African Americans, although these percentages are much
less compared to their groups’ proportion of the country’s population. Another cause is linguistic
barriers whereby language differences limit access to medical care for the ethnic minorities who
are not proficient in English. Moreover, another cause of these disparities is also the lack of a
regular source of care. In most cases, lacking access to regular healthcare makes older patients
have greater difficulty in obtaining care, fewer physician visits, and experience more difficulty in
obtaining prescription drugs/medication. Compared to older whites, older ethic minority
Americans are less likely to have a physician they go to regularly, and are more probable to use
emergency clinics and rooms as their regular source of health care (AHRQ, 2011).
Older women generally tend to have a limited ability to obtaining medical care compared
to older men. This is primarily because they have more frequent reports of disability and
functional limitations, and also because older women are twice as likely to live alone compared
to older men. Thus, older women with healthcare problems may be isolated, hence limiting their
ability to obtain medical care (CNOA, 2013). There is the need for community support of older
citizens, especially those who are isolated by failing health through the loss of friends and
family. Another cause of the disparities is the health care financing system. The fragmentation of
healthcare delivery and financing system in the United States is a barrier to accessing healthcare.
Older ethnic and racial minorities are more likely to be enrolled in health insurance plans that
place limits on the covered services and offer a limited/restricted number of healthcare providers
(AHRQ, 2011). Due to these disparities, older people from ethnic minorities particularly African

Americans, have much less life expectancy compared to older whites. The life expectancy of
blacks is 72.9 compared to 78.1 of whites (CNOA, 2013). Urgent attention is warranted in order
to ensure improvements in healthcare quality among the older ethnic minorities and women in
the United States, and reduce the existing disparities.


Agency for Healthcare Research and Quality. (2011). National Healthcare Disparities Report.

National Council on Aging. (2013). Making a Difference for Older Americans: 1950 – Today.